Lower limb reconstruction repairs the leg and foot after open fractures, crush and degloving injuries, heel pad avulsion, infections, diabetic foot disease, tumours and non-healing wounds. Its aim is limb salvage: clearing infection, stabilising bone and providing durable skin and soft tissue cover, often with microvascular free flaps.
- AnaesthesiaUsually general or spinal
- Hospital stayDays to several weeks, depending on injury
About Lower Limb Reconstruction and Limb Salvage
Injuries and infections of the leg and foot can expose bone, tendons, fixation hardware and joints. Without healthy soft tissue cover, these wounds are at high risk of infection, non-union and amputation. Plastic and reconstructive surgery works alongside orthopaedic care to save limbs and restore walking.
Dr. N. Jithendran's lower limb case gallery includes open grade IIIB and IIIC fractures covered with microvascular latissimus dorsi and anterolateral thigh (ALT) flaps, circumferential degloving injuries treated with debridement and negative pressure wound therapy, heel pad and combined dorsum and sole avulsions, exposed hardware after fracture plating, chronic osteomyelitis of the tibia, necrotising fasciitis, diabetic foot infections salvaged with cross-leg flaps, oncological reconstruction after squamous cell carcinoma of a heel ulcer and recurrent dermatofibrosarcoma of the sole, a high-flow vascular malformation of the foot, and fungal (Aspergillus) foot infection.
Where limb salvage is not possible or safe, as with wet gangrene and multiple medical problems, a well-planned amputation can be the safest option.
Procedures in lower limb
Crush Injuries of the Lower Limb
A crush injury of the lower limb happens when the leg or foot is compressed between heavy objects, damaging skin, muscle, bone, nerves and blood…
Read more →Heel Pad Avulsion Reconstruction
A heel pad avulsion is an injury in which the thick, cushioning skin and fat of the heel is partly or completely torn away, usually in road…
Read more →Open Fractures (Compound Fractures)
An open (compound) fracture is a broken bone that has pierced the skin, exposing it to contamination and damaging nearby muscles and tendons. It is…
Read more →Varicose Veins Treatment
Varicose veins are enlarged, twisted veins, usually in the legs, caused by faulty valves that let blood pool. They can cause aching, swelling, skin…
Read more →Non-Healing (Chronic) Wounds
A non-healing or chronic wound is one that has not improved after about four weeks or closed by eight weeks, such as diabetic foot, venous or…
Read more →Diabetic Foot Salvage and Reconstruction
Diabetic foot salvage and reconstruction is surgery to control infection, remove dead tissue and close diabetic foot ulcers and wounds so the foot…
Read more →Who can benefit?
- People with open fractures and exposed bone or hardware
- Patients with crush, degloving or heel pad avulsion injuries
- People with diabetic foot ulcers and infections
- Patients with chronic osteomyelitis or necrotising fasciitis
- People with non-healing wounds or tumours of the leg and foot
How Dr. Jithendran approaches treatment
- Thorough debridement of dead and infected tissue
- Bone stabilisation together with the orthopaedic team
- Negative pressure wound therapy to prepare the wound
- Skin grafts, local flaps, cross-leg flaps or microvascular free flaps for cover
- Staged surgery and rehabilitation planned for each patient
What is recovery like?
- Limb elevation in the early days to reduce swelling
- Weight-bearing is restricted until grafts, flaps and bone have healed
- Pressure garments and physiotherapy as advised
- Several operations are often needed over weeks to months
What are the risks?
- Infection, including deep bone infection
- Flap or graft failure
- Delayed bone healing or non-union
- Blood clots
- Amputation if salvage is not successful
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
What is limb salvage?
Limb salvage is the effort to save an injured or infected leg or foot instead of amputating it. It combines debridement, bone stabilisation, infection control and soft tissue cover, often with flaps, followed by rehabilitation so the person can walk on the limb again.
What is a free flap and why is it used in the leg?
A free flap is skin, fat or muscle taken from another part of the body, such as the back (latissimus dorsi) or thigh (anterolateral thigh), with its blood vessels, which are joined to vessels in the leg under a microscope. It brings a healthy blood supply to cover exposed bone or hardware.
What is negative pressure wound therapy?
Negative pressure wound therapy, or vacuum-assisted closure, uses a sealed foam dressing connected to gentle suction. It removes wound fluid, reduces swelling and promotes healthy granulation tissue, preparing the wound for a skin graft or flap. It is a step toward closure rather than a replacement for it.
Why see a plastic surgeon for a leg injury?
Many serious leg wounds need both bone fixation and soft tissue cover. Plastic surgeons are trained in debridement, blood supply and wound cover, including microsurgery, and work with orthopaedic surgeons so that fractures heal under healthy, durable tissue.
